Highligting Prep / Early Stages of the Patient Journey with Dr. Andrew Fraval.
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Andrew Fraval
FRACS
St. Vincent's Hospital Melboourne
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This webinar traced how infection prevention in arthroplasty hinges on balancing microbial burden with host resilience, emphasizing that no single measure can eliminate risk. Instead, incremental gains arise from bundles: optimizing comorbidities like diabetes, malnutrition, obesity, and anemia; maintaining normothermia; minimizing contamination; and using evidence-based decolonization, antibiotics, skin prep, and irrigation. Emerging concepts such as gut dysbiosis and Trojan horse mechanisms offer new hypotheses but lack interventional evidence. The discussion underscored the need for large, collaborative, platform-style trials to evaluate pragmatic, frugal interventions across the patient journey and to finally clarify which combinations meaningfully reduce prosthetic joint infection.
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